GENERAL PSYCHIATRISTS AND THEIR PATIENTS’ CHILDREN: ASSESSMENT AND PREVENTION

  General psychiatrists frequently treat adult patients with Major Depressive Disorder. Ordinarily, these psychiatrists focus solely on the treatment of their adult patients. However, new data suggest that treatment efforts might be doubly rewarded if psychiatrists tended to the children of these patients as well. This article reviews the literature on children whose parents have Major Depressive Disorder, and on preventive interventions for their children. We also review challenges to funding interventions of this sort based on systematic interviews of public and private insurance providers. We suggest a new standard of care for depressed patients: reliable screening of the patients’ children for both risk of disorder and resilience as well as referral of these children, where indicated, for prevention services. We review obstacles to this standard of care: the professional reluctance of general psychiatrists to work with children and the lack of screening and preventive services for these children in most practice settings.     

COMPARISON OF THE POLYMORPHISMS OF ANDROGEN RECEPTOR GENE AND ESTROGEN α AND β GENE BETWEEN ADOLESCENT FEMALES WITH FIRST-ONSET MAJOR DEPRESSIVE DISORDER AND CONTROLS

This study was to elucidate the role of genetic variation in androgen receptor (AR) gene, estrogen receptor α (ER α) and ER β gene on first-onset major depressive disorder (MDD) in female adolescents. Results showed that AR gene in MDD group have shorter microsatellites’ length, and ER β gene have shorter microsatellites’ length and higher rates of S alleles, SS, genotype, and lower rate of LL genotype than control group. The results suggest that shorter length of AR and ER β gene microsatellites might influence the onset of MDD in female adolescents, a further elucidation of the mechanisms is warranted.     

CORRELATIVE STUDY OF THE COGNITIVE IMPAIRMENT,REGIONAL CEREBRAL BLOOD FLOW,AND ELECTROENCEPHALOGRAM ABNORMALITIES IN CHILDREN WITH DOWN’S SYNDROME

The aim of this study was to investigate possible correlations of the cognitive impairment with abnormalities of regional cerebral blood flow and electroencephalogram in children with (Down's Syndrome) DS. Nine patients with DS were evaluated by single photon emission computed tomography (SPECT) in combination with clinical findings, electroencephalography (EEG), and magnetic resonance imaging (MRI). In cases with IQs below 40, there were one or more findings of abnormal EEG/MRI and brain perfusion SPECT. In 6 cases (66.7%) EEG findings were normal, but 3 (33.3%) had abnormal EEG findings. Perfusion abnormalities were most pronounced in the fronto-parieto-temporal region in the form of hypoperfusion (n = 5) and in the right hemisphere (n = 5) than the left hemisphere (n = 1). These findings suggest that the children with DS had varying levels of structural, perfusion, and electrophysiological abnormalities in the brain and these abnormalities were reflected by measurable alterations of the cognitive functions.     

Comparing Fathers’ and Mothers’ Perspectives About Their Child’s Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - Mothers are often the primary parent participants in autism spectrum disorder (ASD) research. As a result, little is known about fathers’...     

Moderators of the Relations Between Mothers’ and Fathers’ Parenting Practices and Children’s Prosocial Behavior

Using multilevel modeling, we separately examined the relations between mothers’ and fathers’ parenting practices and children’s prosocial behavior, as well as the moderating roles of child sex, age, and ethnicity. Participants included a diverse community sample of 129 cohabiting couples with a child aged 6–17. Results indicated that paternal positivity and corporal punishment were significantly related to girls’, but not boys’, prosocial behavior, and paternal involvement was related to prosocial behavior in school-aged children but not adolescents. Greater levels of positivity in both parents were related to more prosocial behavior in Caucasian children and less in African American children. Overall, the findings suggest that fathers’ parenting is important and may differentially influence children of different sexes and ages, underscoring the importance of examining both mothers’ and fathers’ parenting in relation to child outcomes and with diverse samples. Findings also highlight the need for culturally appropriate measures of parenting.     

Magnetization transfer imaging in ‘premanifest’ Huntington’s disease

To investigate whether magnetization transfer imaging (MTI) is a useful detector of diffuse brain abnormalities in ‘premanifest’ carriers of the Huntington’s disease (HD) gene mutation. Furthermore we examined the relations between MTI, clinical measures and CAG repeat length. Sixteen premanifest carriers of the HD gene without motor manifestation and 14 non-carriers underwent a clinical evaluation and a MRI scan. MTI analysis of whole brain, grey matter and white matter was performed producing magnetization transfer ratio (MTR) histograms. A lower peak height of the grey matter MTR histogram in carriers was significantly associated with more UHDRS motor abnormalities. Furthermore, a lower peak height of the whole brain, grey and white matter was strongly associated with a longer CAG repeat length. MTI measures themselves did not differ significantly between carriers and non-carriers. In premanifest HD mutation carriers, a lower MTR peak height, reflecting worse histological brain composition, was related to subtle motor abnormalities and higher CAG repeat length. Although we could not detect altered MTI characteristics in carriers of the HD gene mutation without clinical manifestations, we did provide evidence that the MTR peak height might reflect genetic and subclinical disease burden and may be of value in monitoring further disease progression and provide insight in clinical heterogeneity.     

Huntington’s Disease

Huntington’s disease (HD) research is aimed at understanding the root cause of the disorder, for the thrill of uncovering new biology, and for the serious purpose of finding effective therapeutic agents. Molecular genetics has revealed the disease trigger, an inherited unstable CAG expansion in a novel 4p16.3 gene (HD), that lengthens a polyglutamine segment in huntingtin. Now studies with HD patients and model systems that are genetic HD replicas are homing in on the trigger mechanism and the first formative steps that cast HD as a distinct clinical entity. At the same time, assays at the biochemical, cellular, and whole organism levels are starting to yield potential disease modifying genes and candidate drugs. These can be prioritized by testing in a panel of genetic and phenotypic HD mouse models to yield analytical tools for dissecting the early and late stages of the disease process and to maximize the chance of success in trials with HD patients.     

Sneddon’s综合征

Sneddon’s综合征是一组具有皮肤网状青斑及闭塞性脑血管病的慢性复发性临床综合征。其病因尚不明确,可能与抗磷脂抗体及遗传有关。抗凝治疗有效。本文对这一综合征作一概述。     

Experience matters: neurologists’ perspectives on ALS patients’ well-being

Despite the fatal outcome and progressive loss of physical functioning in amyotrophic lateral sclerosis (ALS), many patients maintain contentment in life. It has been shown that non-professionals tend to underestimate the well-being of patients with ALS, but professionals’ perspective is yet to be studied. In total, 105 neurologists with varying degrees of experience with ALS were included in an anonymous survey. They were asked to estimate the quality of life and depressiveness of ALS patients with artificial ventilation and nutrition. Physicians’ estimations were compared with previously reported subjective ratings of ALS patients with life-prolonging measures. Neurologists with significant experience on ALS and palliative care were able to accurately estimate depressiveness and quality of life of ALS patients with life-prolonging measures. Less experienced neurologists’ estimation differed more from patients’ reports. Of all life-prolonging measures neurologists regarded invasive ventilation as the measure associated with lowest quality of life and highest depressiveness of the patients. Experienced neurologists as well as neurologists with experience in palliative care are able to better empathize with patients with a fatal illness such as ALS and support important decision processes.     

Schizographie,l’avant-garde d’un symptôme

Aims

This article sets out to demonstrate the heuristic value of exploration of a notion that originated from clinical observation in a particular psychiatric domain, that of the schizographia/schizophasia dyad, and its effects on the history of psychoanalysis, via the conceptualisation by Lacan. It also looks at the way in which this history contributes to what was at the time the avant-garde of poetry and literature.

Terson’s Syndrome

Background  

Terson’s syndrome is intraocular hemorrhage (IOH) subsequent to subarachnoid hemorrhage (SAH). Its presence is associated with higher mortality in SAH. We report a case of Terson’s syndrome and review the literature.     

Alzheimer’s therapeutics

Factors limiting the therapeutic application of neurotrophins to neurodegenerative diseases include poor stability and CNS penetration. Moreover, certain neurotrophin effects, such as promotion of neuronal death via interaction with the p75NTR receptor, might further limit their application. We have proposed that development of small molecule mimetics of neurotrophins might serve to overcome these limitations. In previous work, our laboratory established the proof-of-principle that mimetics of specific nerve growth factor (NGF) domains could prevent neuronal death. Peptidomimetics of the loop 1 domain prevent death via p75NTR-dependent signaling and peptidomimetics of the loop 4 domain prevent death via Trk-related signaling. In current work we are designing pharmacophore queries corresponding to loop domains 1 or 4 that incorporate features of the NGF crystal structure along with features derived from peptidomimetic structure-activity-relationships. Screening of in silico databases containing non-peptide, small molecules has identified a number of candidate NGF domain mimetics. Preliminary assessment of these compounds using neurotrophin bioassays indicates that several are capable of preventing neuronal death. Ongoing studies will determine whether these compounds act via p75NTR or Trk receptors.     

Counselors’ attachment anxiety and avoidance and the congruence in clients’ and therapists’ working alliance ratings

Objective: To determine how counselors’ attachment anxiety and avoidance related to congruence between counselors’ and clients’ Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients’ WA ratings predicting counselors’ WA ratings. Directional bias was defined as the difference in level between counselors’ and clients’ WA ratings. Method: Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. Results: As hypothesized counselors’ WA ratings were significantly and positively related to clients’ WA ratings. Also as hypothesized, counselors’ WA ratings were significantly lower than their clients’ WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors’ attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Conclusion: Counselors’ attachment anxiety is realted to their ability to accurately percieve their clients’ WA.